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Manifestacja kliniczna chłoniaków złośliwych w regionie głowy i szyi

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Bojanowska-Poźniak K., Nurkowska M., Danilewicz M., Pietruszewska W.
Polish Journal of Otolaryngology
|
2017
|
vol. 71
|
issue 6
14-21
PL
Wstęp: Chłoniaki złośliwe to nowotwory wywołane klonalnym rozrostem komórek limfoidalnych odpowiadających różnym stadiom zróżnicowania prawidłowych limfocytów. Klasyfikacja WHO w oparciu o kryteria genetyczno-immunohistochemiczne dzieli chłoniaki na ziarnicze i nieziarnicze, w każdej grupie wyróżniając liczne podtypy o odmiennym obrazie histologicznym i przebiegu klinicznym. Chłoniaki mogą występować w postaci węzłowej bądź pozawęzłowej. Stanowią one 3–5% wszystkich nowotworów złośliwych w Polsce i są na trzecim miejscu pod względem częstości występowania wśród nowotworów głowy i szyi. Liczba zachorowań na chłoniaki wzrasta o 3–4% na rok, czyniąc je jednymi z najczęstszych nowotworów złośliwych u młodych osób, stanowiących istotny przedmiot zainteresowania współczesnej onkologii. Cel pracy: Ocena obrazu klinicznego i procesu diagnostycznego u pacjentów z chłoniakami złośliwymi zlokalizowanymi w regionie głowy i szyi, a rozpoznanymi w Klinice Otolaryngologii i Laryngologii Onkologicznej Uniwersytetu Medycznego w Łodzi w latach 2013–2017. Materiał i metody: Trzydziestu pacjentów z chłoniakami złośliwymi, diagnozowanych w Klinice Otolaryngologii i Laryngologii Onkologicznej Uniwersytetu Medycznego w Łodzi w latach 2013–2016. Wyniki: W badanej grupie w 8 przypadkach rozpoznano chłoniaki węzłowe, a w pozostałych chłoniaki pozawęzłowe. U 29 pacjentów rozpoznano różne postacie chłoniaków typu B, u jednego – chłoniaka typu T. Najczęstszym objawem była limfadenopatia szyjna lub obecność guza na szyi, a inne dolegliwości były związane z lokalizacją narządową chłoniaków pozawęzłowych. Rozpoznanie stawiano na podstawie materiału pobranego w biopsji cienkoigłowej lub chirurgicznej guza szyi oraz materiału pooperacyjnego lub biopsyjnego w chłoniakach pozawęzłowych. Wnioski: W diagnostyce guzów głowy i szyi należy brać pod uwagę chłoniaki złośliwe. Ze względu na niecharakterystyczny obraz kliniczny oraz konieczność zastosowania panelu badań immunohistochemicznych chłoniaki w tej okolicy mogą stanowić poważny problem diagnostyczny. Rozpoznanie chłoniaków wymaga interdyscyplinarnej współpracy wielu specjalistów.
2
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Clinical manifestation of malignant lymphomas of the head and neck region

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Bojanowska-Poźniak K., Nurkowska M., Danilewicz M., Pietruszewska W.
Polish Journal of Otolaryngology
|
2017
|
vol. 71
|
issue 6
14-21
EN
Introduction: Malignant lymphoma (ML) is a neoplasm caused by clonal expansion of undifferentiated B, T and NK-lymphoid cells. WHO classification divides lymphomas into two main types, i.e. Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL), with numerous subtypes. The majority of MLs are localized in lymph nodes, but extranodal locations are also possible. MLs represent approximately 3-5% of all malignant neoplasms in Poland, but their incidence has been increasing in recent years, especially in young patients. The objective of the study was to evaluate clinical manifestations and diagnostic process in patients with malignant lymphomas of the head and neck region as diagnosed in the Department of Otorhinolaryngology of the Medical University of Lodz in years 2013-2017. Material and method: 30 patients diagnosed with malignant lymphomas of the head and neck region at the Departbadament of Otorhinolaryngology of the Medical University of Lodz in 2013-2017. Results: The study group consisted of 8 cases of nodal lymphomas and 22 cases of extranodal lymphomas. In 29 cases B-cell lymphomas were diagnosed. The most common symptoms included lymphadenopathy or neck tumor. Other symptoms were associated with the location of tumors in particular body organs. The diagnosis was based on histopathological examination of biopsy (needle or surgical) samples. Conclusion: Malignant lymphomas should be taken into account during differential diagnosis of the tumor or lymphadenopathy of the neck. The diagnosis is difficult because of the nonspecificity of symptoms and the need for interdisciplinary cooperation of many specialists.
3
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Patient satisfaction with the perioperative care by anesthesiologists: pilot study at four surgical departments

88%
Springer J., Dudzińska K., Nurkowska M., Hasak L., Dylczyk-Sommer A.
European Journal of Translational and Clinical Medicine
|
2019
|
vol. 1
|
issue 2
58-63
EN
Background The aim of this pilot study was to measure the outcomes of perioperative care by anesthesiologists and patient satisfaction at four surgical departments. Methods We designed an original 25–item questionnaire and used it to complete structured interviews of 80 consenting, alert, adult surgical patients during their 1st to 3rd post–operative day. Results Although >70% were satisfied with the information sharing, 43% patients were unsure or not informed about the possible complications of anesthesia. Similarly, >75% positively rated the anesthesiologists' bedside manner; however 69% were either unsure or sure that an anesthesiologist did not visit them after surgery. Interestingly, this lack of continued care had no overall effect on patient satisfaction. Majority reported receiving immediate post–operative analgesia (65%). The Oncological Surgery patients reported highest (and the Orthopedic patients the lowest) satisfaction with their postoperative nausea and pain management. Majority of responders were overall satisfied with their care. Conclusions Our data indicate a high level of patient satisfaction with nearly all aspects of perioperative anesthesiology care. However, anesthesiologists need to more thoroughly inform patients about possible complications of anesthesia. A larger survey is needed to fully assess the patient care and satisfaction trends discussed above.
4
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Content available

Patient satisfaction with the perioperative care by anesthesiologists: pilot study at four surgical departments

88%
Springer J., Dudzińska K., Nurkowska M., Hasak L., Dylczyk-Sommer A.
European Journal of Translational and Clinical Medicine
|
2019
|
vol. 1
|
issue 2
58-63
EN
Background: The aim of this pilot study was to measure the outcomes of perioperative care by anesthesiologists and patient satisfaction at four surgical departments. Methods: We designed an original 25–item questionnaire and used it to complete structured interviews of 80 consenting, alert, adult surgical patients during their 1st to 3rd post–operative day. Results: Although >70% were satisfied with the information sharing, 43% patients were unsure or not informed about the possible complications of anesthesia. Similarly, >75% positively rated the anesthesiologists' bedside manner; however 69% were either unsure or sure that an anesthesiologist did not visit them after surgery. Interestingly, this lack of continued care had no overall effect on patient satisfaction. Majority reported receiving immediate post–operative analgesia (65%). The Oncological Surgery patients reported highest (and the Orthopedic patients the lowest) satisfaction with their postoperative nausea and pain management. Majority of responders were overall satisfied with their care. Conclusions: Our data indicate a high level of patient satisfaction with nearly all aspects of perioperative anesthesiology care. However, anesthesiologists need to more thoroughly inform patients about possible complications of anesthesia. A larger survey is needed to fully assess the patient care and satisfaction trends discussed above.
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